Western Honduras Copán Population–Based Cancer Registry: Initial Estimates and a Model for Rural Central America

Abstract

PURPOSE Population-based cancer registries (PBCRs) are critical for national cancer control planning, yet few low- and middle-income countries (LMICs) have quality PBCRs. The Central America Four region represents the principal LMIC region in the Western hemisphere. We describe the establishment of a PBCR in rural Western Honduras with first estimates for the 2013-2017 period. METHODS The Western Honduras PBCR was established through a collaboration of academic institutions and the Honduras Ministry of Health for collection of incident cancer data from public and private health services. Data were recorded using the Research Electronic Data Capture (REDCap) web-based platform with data monitoring and quality checks. Crude and age-standardized rates (ASRs) were calculated at the regional level, following WHO methodology. RESULTS The web-based platform for data collection, available ancillary data services (eg, endoscopy), and technical support from international centers (United States and Colombia) were instrumental for quality control. Crude cancer incidence rates were 112.2, 69.8, and 154.6 per 100,000 habitants overall, males, and females, respectively (excluding nonmelanoma skin cancer). The adjusted ASRs were 84.2, 49.6, and 118.9 per 100,000 overall habitants, males, and females, respectively. The most common sites among men were stomach (ASR 26.0, 52.4%), colorectal (ASR 5.11, 10.15%), and prostate (ASR 2.7, 5.4%). The most common sites in women were cervix (ASR 34.2, 36.7%), breast (ASR 11.2, 12.3%), and stomach (ASR 10.8, 11.7%). CONCLUSION The Copán-PBCR represents a successful model to develop cancer monitoring in rural LMICs. Innovations included the use of the REDCap platform and leverage of Health Ministry resources. This provides the first PBCR data for Honduras and the Central America Four and confirms that infection-driven cancers, such as gastric and cervical, should be priority targets for cancer control initiatives.

Upper Gastrointestinal Cancer: Delays in Diagnosis and Treatment Caused by Barriers to Healthcare in the Latino Community

“…This case report exhibits multiple barriers to healthcare that were identified during the patient's prolonged disease course. First, healthcare access is difficult due to hometown being located in a mountainous region of Honduras distant to secondary or tertiary healthcare centers, despite being a known region with a high incidence of upper gastrointestinal neoplasm [18][19][20]. Additionally, in low-middle-income countries, the recommended radiological and endoscopic studies for detecting these intraabdominal conditions are not available in many hospitals and, when available, are expensive, contributing to the delay of diagnosis and treatment [19,21].…”

“…It is known that upper gastrointestinal neoplasms are the leading cause of malignancies and mortality in Central America, and impact the USA health system as Central America forms the second largest Latino immigrant population [18][19][20][21]25].…”

Colorectal Cancer Screening Programs in Latin America

“…While no publication bias was found in our funnel plots, there could be unpublished CRC screening efforts due to implementation failures, constituting infeasibility. The LMIC "double cancer burden" is well-documented, 26,71 with increasing rates of CRC in Latin American lower-and upper-middleincome countries, emphasizing the need for research on CRC prevention in the region.…”

Management of a Right Heart Intracavitary Thrombus in Transit in a Patient With Gastric Cancer in a Resource-Limited Setting: A Case Report

“…Gastric cancer (GC) is frequently complicated by hypercoagulation, with an associated risk of thromboembolic complications (TECs) [ 1 ]. An epidemiological study assessed the risk of having GC in Honduras, with a population-based cancer registry reporting an age-standardized risk of GC of 25.96 per 100,000 in males and 10.84 per 100,00 in females in a rural region representative of the population during five years of surveillance [ 2 ]. Treatment and histological classification also significantly influence the risk for TECs.…”